Endarterectomy

Definition

Atherosclerosis
is hardening of a blood vessel from a buildup of plaque. Plaque is made of fatty deposits, cholesterol, and calcium. It builds on the inside lining of arteries. This causes the artery to narrow and harden. As plaque builds up, it can slow and even stop blood flow.

Endarterectomy is a surgery to remove this build-up and improve blood flow. Surgery is most often performed on:

Carotid arteries in the neck that supply the brain—most common use of endarterectomy

Reasons for Procedure

This surgery is done to remove the build-up of deposits and improve blood flow. After the surgery, the symptoms of reduced blood flow, such as
stroke, digestive problems, and leg cramps should
improve.

Possible Complications

If you are planning to have endarterectomy, your doctor will review a list of possible complications, which may include:

Bleeding

Stroke, particularly if the carotid arteries are involved

Blood clots

Adverse reaction to the anesthesia

Infection

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

Your risk of complications may also be increased if you have plaque build-up in other vessels.

What to Expect

Prior to Procedure

Before the surgery, your doctor will:

Give you an exam to make sure that you are healthy enough for the surgery

Order studies that
show detailed images of your arteries

Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.

In addition, you may be instructed to:

Avoid eating or drinking after midnight the night before the surgery.

Arrange for a ride home from the hospital.

Anesthesia

You may have:

General anesthesia—blocks any pain and keeps you asleep through the surgery; given through an IV

Local anesthesia—numbs an area of your body so that you stay awake through the surgery; may be given as an injection

Description of the Procedure

Incisions will be made over the diseased part of the artery. The location will depend on the artery that is being unblocked.

In the abdomen and legs, the artery above the obstruction will be clamped during the repair. The lower half of the body can go without blood supply during the time it takes to do the surgery. If surgery is done on the neck, the blood around the surgical site may first be rerouted. This will keep blood going to the brain.

The inside of the artery will be cleaned out. Care will be taken not to have small fragments of the deposits break off and flow downstream, causing stroke or arterial occlusion. After the artery is cleaned out, the artery and the skin will be closed with sutures or staples.

How Long Will It Take?

Several hours, depending on the severity of the disease

How Much Will It Hurt?

After surgery, there will be pain from the incisions. Ask your doctor about medication to help reduce discomfort.

Average Hospital Stay

This procedure is done in a hospital setting. The usual length of stay is one day to one week. You may need to stay longer if complications occur.

Post-procedure Care

At the Hospital

While you are recovering at the hospital, you may receive the following care:

You will be monitored to make sure that you are not bleeding, clotting, or developing an infection.

You will also be monitored to make sure that your wound is healing properly and that your pain is managed.

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

Washing their hands

Wearing gloves or masks

Keeping your incisions covered

There are also steps you can take to reduce your chances of infection such as:

Washing your hands often and reminding visitors and healthcare providers to do the same

Reminding your healthcare providers to wear gloves or masks

Not allowing others to touch your incisions

At Home

When you return home, do the following to help ensure a smooth recovery:

If advised by your doctor, take blood thinners.

To help reduce the risk of plaque build-up, make changes to your diet, such as eating a diet:

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.